Author: Sinead

Perpetually curious, gamer, Science Communication graduate, healthcare admin, too pedantic for my own good.

Dissociative Disorder Diagnosis Adventure

20 March 2015 / Sinead

For people in the UK, there are two ways to go about investigating dissociative disorders (using that as the catch-all term for everything on the dissociative symptom spectrum).

The first option to to straight-out ask your GP, if you have an alright relationship with them. As the majority of GP’s won’t be knowledgeable about dissociation, that will probably involve bringing some information about it to the appointment. It would also be best to specifically asking for a referral to the Clinic for Dissociative Studies, rather than a local psychologist.

If you’re not sure how your GP will respond, or want extra support in the decision beforehand, then another option is to contact the Pottergate Centre, a dissociation-focused organisation with an office in Norwich, UK. They have an online contact option, where you can get two dissociation screening tests from them, and send the tests back to them to be analysed, all for free. You can then take the results, and their analysis, to your GP- they will also include extra information about dissociation with the results.

This method, asking the Pottergate Centre, is how I’m taking my first steps into exploring whether my experiences fit a dissociative disorder, and if so, whether getting a diagnosis is a good idea.

Facebook Suicide Prevention Initiative

12 March 2015 / Sinead

On February 25th, Facebook’s safety division announced an extension of their suicide prevention initiative. They describe the initiative as being based on work with suicide prevention organisations, clinical research, and lived experiences from mental health survivors.

From what I’ve seen so far, parts of this initiative seem beneficial, and useful for helping people through a bad night or self-destructive impulse. However, there are still some concerning areas, and there has already been at least one example of just how this initiative can be dealt with wrongly.

The Benefits

Firstly I’ll go through its helpful aspects. The idea of pointing out that the post suggests someone is upset or distressed could be effective. Receiving this message might be the shock that lets someone realise they are having difficulties beyond typical ups and downs, and so might encourage them to see what the offered help is.

From the other side, allowing people to send an anonymous “someone thinks you might be in trouble” message reduces one of the barriers people often have in talking about mental health issues. It starts the conversation in a low-risk way, without requiring the face-to-face questions that many people just don’t know how to carry out.

Facebook’s post showed some pictures of the support options. The support page offers the following message:

Itch.io Cyberpunk Jam

26 February 2015 / Sinead

Cyberpunk is one of my favourite genres both in fiction and in gaming, and telling me a game is cyberpunk-influenced is a good way of guaranteeing my interest (well, that or cel-shading). So finding out that Itch.io– a game-dev community that I’ve often heard about but never really investigated- had a whole section of cyberpunk games ready to try definitely got my attention.

Here are a few highlights; mostly from the 2014 Cyberpunk Game Jam.

VA-11 Hall-A

We’re used to seeing the heroes, villains, and morally-ambiguous characters of cyberpunk in action, but who are they when they finish work? Who populates the world away from the camera?

VA11 Hall-A, described as a bartender-em-up, lets us look at the personal lives behind the often-impersonal world of neon, skyscrapers and megacorporations.

Treating Mental Health Issues: Definitions

20 February 2015 / Sinead

When talking about treating mental health issues, it’s important to look at what medical staff, researchers, and people with mental health issues consider to be successful treatment. As its a lot harder to measure and accurately define mental health symptoms than physical ones, it is harder to accurately judge treating them. To show what kind of terms are used when treating mental health conditions, I’m using some hypothetical case studies. Imagine that each of these patients has just been diagnosed as being in their first Major Depressive Episode, and this is their first mental health issue. Each patient starts with a score of 18 on the PHQ-9, representing moderately severe depression using that system, is treated with an antidepressant, and is followed up six months later.

Response

After a six-week course of medication, Patient A retakes the PHQ-9 and scores 14. Six months later, their score is 15. Because their score has stayed lower, Patient A has had a treatment response. Their diagnosis would not change. In a purely medical sense, this is progress. An academic study testing the effectiveness of patient A’s antidepressant would be happy with a 3-point response, and would consider this a successful response. However, the patient themselves won’t see it that way.

A score of 15 is still in the category of moderately severe depression. Their day-to-day feelings and experiences may not have changed in any meaningful way and, depending on what side-effects the medication had, they may not feel the treatment was worth having.

My Diagnosis Experience, Part 4

15 February 2015 / Sinead

Background

Despite having sat through my fair share of mental health assessments, I don’t know much about them. As I don’t personally know anyone who has experienced one, and don’t really have many people I could ask about how they work, my knowledge is entirely from what people have said online.

Out of everything I’ve written about in the last few posts, one meeting has always remained in my mind, because it was simultaneously the worst and the best experience I had with mental health professionals.

Having never had anyone to “compare notes” with, I’m going to explain it here, in case it comes in useful for future reference or for anyone else. Again, personal information has been removed.

The Psychology of Freemium Gaming: Social Interaction Required

13 February 2015 / Sinead

A cousin of the paywall and skill gate is the social fence. This is where a game, instead of requiring tangible goods for you to proceed, depends on existing or new social connections.

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Gaming being enhanced by adding friends isn’t a new concept- multiplayer videogames have been around since 1958. Explicitly requiring friendships to progress through a game is, however, a much newer trend.

Social Network games such as Farmville and Zynga’s entire catalogue are the most well-known users of this mechanic; spawning multitudes of fans, followers, and imitators. Not forgetting the universal heart-seeking Candy Crush notifications.

These games typically work by connecting the energy mechanic I spoke about before with a social mechanic. If a player would initially need to wait 6 hours to continue after running out of energy, a social gate could be created as an alternative. This could be by calling in a friend’s assistance; having a friend start playing the game would cancel that wait.

Instead of paying to recover a life, HP can be regenerated from having someone accompany you, while tricky levels can be solved via remote hints from another player. Now we hit a problem, because these abilities are the source of payment in freemium games. If these abilities are social instead, where is the earning potential?

The Psychology of Freemium Gaming: Energy and Action

12 February 2015 / Sinead

You have full energy!…

While boxed game releases used to mean one large payment for one large game, that idea isn’t a certainty any more. Episodic games often occupy the midpoint of the price-content spectrum, while some AAA games aim for everywhere on the spectrum at once; a full game for a full price, a season pass on top, then microtransactions on top of that.

For AAA games, microtransactions rely on keeping the momentum of playtime going- for longer, either by unlocking new items early, or by increasing rewards. However, major freemium games instead aim for “micro-gaming”- limiting people to short, regular chunks of gameplay. Transactions can act as micro-monetisation -exchanging a little bit of money for a little bit of time saved.

The Psychology of Freemium Gaming: Gates, Walls and Curves.

9 February 2015 / Sinead

Freemium games often have very low difficulty curves, and low barriers to success, as part of their casual nature. However, they will usually corner players with a paywall after the introductory rush of success has worn off.

Paywalls aren’t all created equal- some can block players from continuing easily, while others are used mainly to add extra features. A “soft” paywall might be something like the ability to unlock a bonus character or go to a new level for a fee. A “hard” paywall might be requiring hard currency for weapon upgrade, making characters progressively underlevelled without payment, or blocking their ability to resurrect themselves.

While a freemium game blocking progression outright is thankfully uncommon, many casual games will instead make progressing easy but perfection impossible for free players.

Some freemium games, such as Minion Rush, will leave actual gameplay intact, confining paywalls to cosmetic items. MR keeps most upgrades feasible, the main pay incentive being costumes that provide currency or skill boosts. While a skill upgrade can be earned in half an hour of competent play, new costumes could take days of high-level play to achieve.

My Diagnosis Experience, Part 3

5 February 2015 / Sinead

Note ; I’m not going to use any identifying information, so I’ll refer to each person by a letter+ number to tell them apart, as it does get rather confusing. The colour-coding is also just to keep track.

K1– university counsellor
K2– university wellbeing practitioner
L– a close friend who I needed to bring with me to some meetings.
C1– first mental health assessor at the community services.
C2– second assessor at the community services.
C3– final assessor at the community services.

Community Mental Health Services

I was referred to the community mental health services (CMS for short) 3 separate times; once from the hospital, once when I finished seeing K1, and by K2 during the relapse I mentioned earlier. This meant I had 3 separate mental health assessments in just over a year.

Each time I was assessed like I’d never been there before, with a different staff member. This seemed really inefficient, especially as each asked me the same questions and mentioned me having used the services recently.

My first assessor C1 was friendly, and I was able to talk to her. However, while I went in assuming my issue was solely/mostly depression and I would be offered CBT, C1 threw a curveball by giving me a leaflet for Mentalization Based Therapy, a treatment for Borderline Personality Disorder.

Facebook as a mental health resource

The Benefits

Response

Background

Community Mental Health Services